Discrimination disguised as public health policy

UK opposition-party leader Michael Howard announced last week that his party would deny visas to prospective immigrants who test positive for tuberculosis (TB). HIV tests would also be mandatory under the Conservative policy.

This is ostensively, a strategy to minimise public-health threats posed by immigrants and similar to current Labour policies and possibly designed to frighten the public rather than protect public health. But the heated debate generated may obscure a more important issue: that disease must not be a basis for discrimination.

A steady increase in newly diagnosed HIV infections in the UK has been blamed on migration. Publicity material exaggerates the burden of immigration-related illness, absolute numbers remaining small.

According to the Health Protection Agency’s most recent report, the number of newly diagnosed HIVinfections thought to have been contracted outside the UK in 2003 number was only around 3000.

Reacting to public fears over perceived threats, Canada, USA, Australia, and New Zealand, have adopted stringent policies for compulsory screening of new entrants for TB and HIV.The UK public inquiry into the issue came out firmly against the idea, concluding that “there is no evidence to suggest that such a policy would be effective at protecting public health”. Grave concerns that the government was seeking ways to “exclude vulnerable individuals on the basis of poor health” were expressed by the All Party Parliamentary Group on AIDS, entire sections of society risk being stigmatized by policies such as these Technical weaknesses in health-check facilities preclude achievement of their alleged protective purpose and by selecting just two diseases for scrutiny some of the most immediate risks are ignored. Arrivals from EU countries will be under no obligation to undergo testing before entering the UK.

The former communist states of eastern Europe have some of the highest rates of TB in the world.